- Lincoln Financial (Tallahassee, FL)
- …for this opportunity. **Requisition #:** 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product subject matter ... for multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. You will… more
- Molina Healthcare (Orlando, FL)
- **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance ... standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases in which a formal appeals… more
- HCA Healthcare (Gainesville, FL)
- …local, state and federal agencies and accrediting bodies. The Inpatient Coding Denials Specialist must ensure timely, accurate, and thorough appeals for all ... that invests in you as an Impatient Coding Denial Specialist ? At Parallon, you come first. HCA Healthcare has...We are looking for a dedicated Impatient Coding Denial Specialist like you to be a part of our… more
- AssistRx (Maitland, FL)
- …coverage provided for a specific pharmaceutical product. The Patient Access Specialist will support the healthcare providers addressing questions regarding coding ... (PA) for an assigned caseload and helps navigate the appeals process to access medications. + Ensure cases move...+ Document and initiate prior authorization process and claims appeals + Report any reimbursement trends or delays in… more
- LogixHealth (Dania Beach, FL)
- Location: On-Site in Dania Beach, FL This Role: As a Junior Medical Billing Specialist at LogixHealth, you will work with a team of fellow medical billers, ... reports to follow up on unpaid claims + Prepare and submit out appeals on claims that require additional review or reconsideration + Provide necessary documentation… more
- LogixHealth (Dania Beach, FL)
- Location: On-Site in Dania Beach, FL This Role: As a Billing Specialist at LogixHealth, you will work with a team of fellow medical billers, administrators, and ... to follow up on unpaid claims + Send out appeals on claims that require an appeal + Submit...professional healthcare billing + Familiarity with payer regulations, claims appeals processes, and denial reasons + Proficiency in EHR… more
- Gehring Group (Palm Beach Gardens, FL)
- …Gehring Group! (https://www.youtube.com/watch?v=N7lGEywlemk) We are seeking a Client Service Specialist (CSS) to join our Account Management department. The Account ... become well-versed in employee benefits and wellness programs. The Client Service Specialist serves as an "advocate" to our Clients' employees, assisting with and… more
- Bristol Myers Squibb (Tampa, FL)
- …Read more: careers.bms.com/working-with-us . **Job Summary** The position of Senior Specialist , Benefit Operations plays a central role in managing and coordinating ... and provide case resolution. + Compile and present relevant data for second-level appeals . + Review and make timely updates to employee reference materials and… more
- CVS Health (Tallahassee, FL)
- …Responsibilities - Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity ... written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals . - Insures all compliance requirements are satisfied and all… more
- United Therapeutics (Melbourne, FL)
- …skills who can effectively handle questions pertaining to prior authorizations, denials and appeals . You have a keen attention to detail and are able to ensure ... do what you can to help our patients. The Access & Support Specialist provides limited reimbursement support services to healthcare providers and patients in keeping… more
- Globus Medical, Inc. (FL)
- …including processing payments by phone, setting up payment plans, and filing appeals + Follows-up with payers, patients, and other appropriate parties to collect ... open billings in a timely manner + Responds to inquiries from customers or external collection resources + Places calls and sends messages to those with unresolved issues + Identifies and reports to management any payer issues with regards to billing and… more
- MyFlorida (Fort Lauderdale, FL)
- …determinations received from claimants and employers or the Office of RA Appeals and the Reemployment Assistance Appeals Commission. Issues written ... is maintained and available to the Office of RA Appeals for lower level appeals hearings. Required...is an OPS Employment Security Representative II- Employment Review Specialist position in the Department of Commerce's Reemployment Assistance… more
- MyFlorida (Orlando, FL)
- …This is an OPS Employment Security Representative II- Employment Review Specialist position in the Department of Commerce's Reemployment Assistance Programs ... from claimants and employers or the Office of RA Appeals and the Reemployment Assistance Appeals Commission....of RA Appeals and the Reemployment Assistance Appeals Commission. Issues written redeterminations relative to the information… more
- MyFlorida (Tallahassee, FL)
- …This is an OPS Employment Security Representative II- Employment Review Specialist position in the Department of Commerce's Reemployment Assistance Programs ... from claimants and employers or the Office of RA Appeals and the Reemployment Assistance Appeals Commission....of RA Appeals and the Reemployment Assistance Appeals Commission. Issues written redeterminations relative to the information… more
- AC Disaster Consulting (Tallahassee, FL)
- …facing our nation. Position Summary: Job Title: Senior Individual Assistance Program Specialist - Multiple Levels ( Senior Consultant I, Senior Advisor, and Managing ... and helpful allies for our clients. The Individual Assistance Specialist for Disaster Recovery Services will play an integral...to manage complex cases and assist with documentation or appeals . + Skilled in coordinating with community partners and… more
- University of Florida (Gainesville, FL)
- …(AAPC) or one of the following required: Certified Coding Specialist (CCS-P)/Certified Coding Assistant (CCA)/Registered Health Information Administrator (RHIA). Job ... and identify opportunities for improvement. * Compiles documentation for appeals to substantiate reimbursement including coding language, medical record… more
- Adecco US, Inc. (Orlando, FL)
- …prior authorization * Provide patient access support related to claims, denials, and appeals * Facilitate training on payer landscape and hub support services * ... 8:00 AM - 5:00 PM (field-based) * Weekly paycheck * Dedicated Onboarding Specialist & Recruiter * Access to Adecco's Aspire Academy with thousands of free… more
- Cognizant (Tallahassee, FL)
- …implementation of process initiatives to reduce denials. The Accounts Receivable Specialist role responsibilities include following up directly with payers to ... action to resolve accounts including drafting and submitting technical appeals . **Key Responsibilities:** + **Problem Solving** : Use exceptional problem-solving… more
- Cardinal Health (Doral, FL)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will ... the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials, to ensure timely and accurate reimbursement. + Processes… more
- Bristol Myers Squibb (Tampa, FL)
- …for escalation and resolution of Tier 2 queries, plan interpretation and appeals . + Responsible for ensuring internal processes are documented and updated versions ... Workday, ServiceNow, ADP and vendor management. + Certified Employee Benefits Specialist (CEBS) or equivalent Industry designation, preferred. \#LI-Hybrid If you… more